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Rheumatological diseases

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https://www.readbyqxmd.com/read/27905201/the-symptom-matrix-using-a-formalism-based-approach-to-address-complex-syndromes-systematically
#1
Jennifer D Skillen
Complex rheumatological syndromes such as Systemic lupus erythematosus, Sjogren's Syndrome and many connective tissue disorders can be a challenge to classify and diagnose, due to their wide-ranging signs and symptoms, not all of which will necessarily be present in all patients. This can result in difficulties for the clinician, patient and researcher if signs and symptoms are either overlooked or are incorrectly included in the nosology or classification of diseases. This article presents a formalism-based approach to describing syndromes...
December 1, 2016: Musculoskeletal Care
https://www.readbyqxmd.com/read/27904996/-methodological-approaches-in-the-development-of-clinical-guidelines
#2
REVIEW
K Albrecht
Practical guidelines assist the clinical decision-making process in modern medicine. In rheumatology the number of practical guidelines dealing with diagnostics and therapy of rheumatic diseases is also constantly increasing. Methodological standards for guidelines ensure adequate development under consideration of precisely defined structures. Expert recommendations for action (S1) are distinguished from consensus (S2k) or evidence-based (S2e) as well as consensus and evidence-based (S3) guidelines. Levels of evidence categorize available studies by study design...
November 30, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27904829/systemic-kikuchi-fujimoto-disease-bordering-lupus-lymphadenitis-a-fresh-look
#3
Aram Behdadnia, Seyyed Farshad Allameh, Mehrnaz Asadi Gharabaghi, Seyed Reza Najafizadeh, Ahmad Tahamoli Roudsari, Alireza Ghajar, Morsaleh Ganji, Mohsen Afarideh
A 31-year old woman with persistent fever for 6 weeks and unresponsive to antibiotic therapy came for rheumatologic investigation. After computed tomography (CT) studies of her neck, thorax and abdomen revealed bilateral cervical, axillary and retroperitoneal lymph node enlargements, histopathologic evaluation of the resected nodes showed features of histiocytic necrotizing lymphadenopathy suggestive of Kikuchi-Fujimoto's lymphadenopathy. Kikuchi-Fujimoto Disease (KFD) involving the retroperitoneal nodes is extremely unusual and even more challenging to diagnose when there are no early signs of extranodal involvement or abdominopelvic pain...
November 2016: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/27903264/adult-onset-still-s-disease-evaluation-of-prognostic-tools-and-validation-of-the-systemic-score-by-analysis-of-100-cases-from-three-centers
#4
Piero Ruscitti, Paola Cipriani, Francesco Masedu, Daniela Iacono, Francesco Ciccia, Vasiliki Liakouli, Giuliana Guggino, Francesco Carubbi, Onorina Berardicurti, Paola Di Benedetto, Marco Valenti, Giovanni Triolo, Gabriele Valentini, Roberto Giacomelli
BACKGROUND: Adult-onset Still's disease (AOSD) is rare inflammatory disease of unknown etiology that usually affects young adults. The more common clinical manifestations are spiking fevers, arthritis, evanescent rash, elevated liver enzymes, lymphadenopathy, hepatosplenomegaly, and serositis. The multi-visceral involvement of the disease and the different complications, such as macrophage activation syndrome, may strongly decrease the life expectancy of AOSD patients. METHODS: This study aimed to identify the positive and negative features correlated with the outcome of patients...
December 1, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27902749/risk-factors-associated-with-renal-involvement-in-childhood-henoch-sch%C3%A3-nlein-purpura-a-meta-analysis
#5
Han Chan, Yan-Ling Tang, Xiao-Hang Lv, Gao-Fu Zhang, Mo Wang, Hai-Ping Yang, Qiu Li
BACKGROUND AND OBJECTIVE: Henoch-Schönlein purpura (HSP) is an important cause of chronic kidney disease in children. This meta-analysis identified risk factors associated with renal involvement in childhood HSP. METHODS: PubMed, Embase, and Web of Science were searched. The quality of all eligible studies was assessed using the Newcastle-Ottawa scale criteria. An analysis of possible risk factors was conducted to report the odds ratio (OR) and weighted mean difference (WMD)...
2016: PloS One
https://www.readbyqxmd.com/read/27902615/the-prognostic-significance-of-the-birmingham-vasculitis-activity-score-bvas-with-systemic-vasculitis-patients-transferred-to-the-intensive-care-unit-icu
#6
Federico Biscetti, Angela Carbonella, Federico Parisi, Silvia Laura Bosello, Franco Schiavon, Roberto Padoan, Elisa Gremese, Gianfranco Ferraccioli
Systemic vasculitides represent a heterogeneous group of diseases that share clinical features including respiratory distress, renal dysfunction, and neurologic disorders. These diseases may often cause life-threatening complications requiring admission to an intensive care unit (ICU). The aim of the study was to evaluate the validity and responsiveness of Birmingham Vasculitis Activity Score (BVAS) score to predict survival in patients with systemic vasculitides admitted to ICU.A retrospective study was carried out from 2004 to 2014 in 18 patients with systemic vasculitis admitted to 2 different Rheumatology divisions and transferred to ICU due to clinical worsening, with a length of stay beyond 24 hours...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27900999/evaluating-anti-smd1-amino-acid-83-119-peptide-reactivity-in-children-with-systemic-lupus-erythematosus-and-other-immunological-diseases
#7
Hai-Ou Yang, Xiao-Qing Zhang, Qi-Hua Fu
BACKGROUND: SmD1-amino-acid 83-119 peptide (SmD183-119) is the major epitope of Smith (Sm) antigen, which is specific for adult systemic lupus erythematosus (SLE). The anti-SmD183-119 antibody has exhibited higher sensitivity and specificity than anti-Sm antibody in diagnosing adult SLE. However, the utility of anti-SmD183-119antibodies remains unclear in children with SLE (cSLE). This study aimed to assess the characteristics of anti-SmD183-119antibody in the diagnosis of cSLE. METHODS: Samples from 242 children with different rheumatological and immunological disorders, including autoimmune diseases (SLE [n = 46] and ankylosing spondylitis [AS, n = 11]), nonautoimmune diseases (Henoch-Schonlein purpura [HSP, n = 60], idiopathic thrombocytopenia purpura [n = 27], hematuria [n = 59], and arthralgia [n = 39]) were collected from Shanghai Children's Medical Center from March 6, 2012 to February 27, 2014...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27900335/a-rare-presentation-of-peritoneal-tuberculosis-mimicking-malignancy
#8
Thein Swe, Akari Thein Naing, Zaw Win Phyo, Malar Thwin
Our search of literature revealed combined elevations of serum cancer antigen 125 levels and rheumatoid factor levels in a patient with peritoneal tuberculosis has rarely been reported. Thus, we describe the case of a 63-year-old female with large abdominal ascites and malignancy was ruled out with biopsy. High levels of serum cancer antigen and rheumatoid factor were noted. Physicians should be aware that tuberculosis infection could induce elevation of rheumatoid factor levels in the absence of rheumatologic symptoms or disease...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27896522/tapering-biologics-in-rheumatoid-arthritis-a-pragmatic-approach-for-clinical-practice
#9
Aleksander Lenert, Petar Lenert
Optimal rheumatoid arthritis (RA) therapy in daily clinical practice is based on the treat-to-target strategy. Quicker escalation of therapy and earlier introduction of biological disease-modifying anti-rheumatic drugs have led to improved outcomes in RA. However, chronic immunosuppressive therapy is associated with adverse events and higher costs. In addition, our patients frequently express a desire for lower dosing and drug holidays. Current clinical practice guidelines from the American College of Rheumatology and European League Against Rheumatism suggest that rheumatologists consider tapering treatment after achieving remission...
November 28, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27890486/towards-a-multidisciplinary-approach-to-understand-and-manage-obesity-and-related-diseases
#10
REVIEW
Stephan C Bischoff, Yves Boirie, Tommy Cederholm, Michael Chourdakis, Cristina Cuerda, Nathalie M Delzenne, Nicolaas E Deutz, Denis Fouque, Laurence Genton, Carmen Gil, Berthold Koletzko, Miguel Leon-Sanz, Raanan Shamir, Joelle Singer, Pierre Singer, Nanette Stroebele-Benschop, Anders Thorell, Arved Weimann, Rocco Barazzoni
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens...
November 16, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27890171/barriers-to-immunizations-and-strategies-to-enhance-immunization-rates-in-adults-with-autoimmune-inflammatory-diseases
#11
REVIEW
Elizabeth Kirchner, Victoria Ruffing
For as long as there have been immunizations, there have been barriers to them. Immunization rates in the United States are below target. Rheumatologists and rheumatology practitioners need to understand the issues of immunizations in patients with autoimmune inflammatory disease to identify and overcome barriers to immunization. Several strategies for overcoming these barriers are discussed.
February 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/27889859/chronic-high-dose-glucocorticoid-therapy-triggers-the-development-of-chronic-organ-damage-and-worsens-disease-outcome-in-systemic-lupus-erythematosus
#12
Tünde Tarr, Gábor Papp, Nikolett Nagy, Edina Cserép, Margit Zeher
Long-term survival of patients with systemic lupus erythematosus (SLE) improved worldwide; thus, prevention of cumulative organ damage became a major goal in disease management. The aim of our study was to investigate the chronic organ damages and their influence on disease outcome in SLE. We evaluated clinical conditions, laboratory findings and medications of 357 consecutive SLE patients and assessed their impact on Systemic Lupus Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) and disease outcome...
November 26, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27889826/cardiovascular-risk-profiles-in-a-hospital-based-population-of-patients-with-psoriatic-arthritis-and-ankylosing-spondylitis-a-cross-sectional-study
#13
Christoffer B Nissen, Kim Hørslev-Petersen, Jette Primdahl
The objective of the study was to investigate the frequency of traditional risk factors for the cardiovascular (CV) disease, to calculate the Systematic COronary Risk Evaluation (SCORE) for CV-related mortality in Danish patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS), and to compare with results from patients with rheumatoid arthritis (RA) from the same settlement. All PsA and AS patients aged 18-85 years from one outpatient clinic were invited. A rheumatology nurse conducted 30-min screening consultation, preceded by a lipid and glucose profile...
November 26, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27889300/tofacitinib-versus-biologic-treatments-in-patients-with-active-rheumatoid-arthritis-who-have-had-an-inadequate-response-to-tumor-necrosis-factor-inhibitors-results-from-a-network-meta-analysis
#14
Maria-Cecilia Vieira, Samuel H Zwillich, Jeroen P Jansen, Brielan Smiechowski, Dean Spurden, Gene V Wallenstein
PURPOSE: Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). This analysis compared the efficacy and safety of tofacitinib with biologic disease-modifying antirheumatic drugs in patients with RA and a prior inadequate response (IR) to tumor necrosis factor inhibitors (TNFi). METHODS: A systematic literature review identified 5 randomized placebo-controlled trials that evaluated tofacitinib or biologic disease-modifying antirheumatic drugs (bDMARDs) against placebo in patient populations with RA with a prior IR to TNFi...
November 23, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27888342/putting-recommendations-into-practice-australian-rheumatologists-opinions-on-leflunomide-use-in-rheumatoid-arthritis
#15
Ashley M Hopkins, Michael D Wiese, Catherine E O'Doherty, Susanna M Proudman
Leflunomide is the most recently introduced conventional disease-modifying anti-rheumatic drugs in Australia. It has several unique methods for initiation, unique monitoring recommendations and a distinctive cessation protocol in the event of serious toxicity. The aim of this study was to evaluate initiation and monitoring practices of Australian rheumatologists using leflunomide. A survey was emailed twice, approximately 3 months apart to 332 rheumatologist members of the Australian Rheumatology Association...
November 25, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27886939/development-and-implementation-of-models-of-care-for-musculoskeletal-conditions-in-middle-income-and-low-income-asian-countries
#16
REVIEW
Keith K Lim, Madelynn Chan, Sandra Navarra, Syed Atiqul Haq, Chak Sing Lau
This chapter discusses the challenges faced in the development and implementation of musculoskeletal (MSK) Models of Care (MoCs) in middle-income and low-income countries in Asia and outlines the components of an effective MoC for MSK conditions. Case studies of four such countries (The Philippines, Malaysia, Bangladesh and Myanmar) are presented, and their unique implementation issues are discussed. The success experienced in one high-income country (Singapore) is also described as a comparison. The Community Oriented Program for Control of Rheumatic Diseases (COPCORD) project and the role of Asia Pacific League of Associations for Rheumatology (APLAR), a professional body supporting MoC initiatives in this region, are also discussed...
June 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27886804/sarcoidosis-rheumatology-perspective
#17
REVIEW
Arthur M F Yee
Sarcoidosis is a systemic inflammatory granulomatous disease for which rheumatologists are uniquely trained and qualified to treat. Historically, sarcoidosis has been managed within silos of medical subspecialties, but with increased appreciation of the systemic nature of this disorder and the availability of more therapeutic options, it is clear that a multidisciplinary approach, with the rheumatologist as a key component, can offer more optimal care. This manuscript reviews clinically relevant immunology and pathophysiology, diagnostic issues, management decision-making, and therapeutics in the care of patients with sarcoidosis...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27886693/gaps-in-aging-research-as-it-applies-to-rheumatologic-clinical-care
#18
REVIEW
Una E Makris, Devyani Misra, Raymond Yung
The incidence and prevalence of rheumatologic conditions are increasing and the rheumatology workforce must be aware of aging-specific issues. This article reviews specific barriers to understanding the biology of aging and aging-related mechanisms that may underlie development of rheumatologic diseases in older adults. It summarizes gaps in the assessment, outcomes measurement, and treatment of these diseases in this unique population. It also highlights potential solutions to these barriers and suggests possible ways to bridge the gap, from a research and education standpoint, so that clinicians can be better prepared to effectively manage older adults with rheumatologic conditions...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886691/pharmacotherapy-pearls-for-the-geriatrician-focus-on-oral-disease-modifying-antirheumatic-drugs-including-newer-agents
#19
REVIEW
Ann J Biehl, James D Katz
Providing safe and effective pharmacotherapy to the geriatric patients with rheumatological disorders is an ongoing struggle for the rheumatologist and geriatrician alike. Cohesive communication and partnership can improve the care of these patients and subvert adverse outcomes. Disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the newest oral agent for treatment of rheumatoid arthritis, tofacitinib, have distinctive monitoring and adverse effect profiles...
February 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27886444/incidence-and-classification-of-cutaneous-manifestations-in-rheumatoid-arthritis
#20
Mirjana Ziemer, Anne-Katrin Müller, Gert Hein, Peter Oelzner, Peter Elsner
BACKGROUND AND OBJECTIVE: There have only been few studies examining rheumatoid arthritis (RA)-related skin manifestations in larger patient populations. Herein, we present current data on the prevalence and spectrum of cutaneous lesions in RA, addressing disease activity scores, anti-CCP antibodies as well as novel pharmacological approaches. PATIENTS AND METHODS: Between November 2006 and July 2007, 214 patients with RA treated at the Division of Rheumatology, University Hospital Jena, Germany, were prospectively examined...
November 25, 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
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